Preventing Violence and Related Health-Risking Social Behaviors in Adolescents

OBJECTIVES: The evidence review was conducted to address six key questions mandated in the Task Order: 1. What are the factors that contribute to violence and associated adverse health outcomes in childhood and adolescence? 2. What are the patterns of co-occurrence of these factors? 3. What evidence exists on the safety and effectiveness of interventions for violence? 4. Where evidence of safety and effectiveness exists, are there other outcomes beyond reducing violence? If so, what is known about effectiveness by age, sex, and race/ethnicity? 5. What are commonalties of the interventions that are effective and those that are ineffective? What are the priorities for future research? DATA SOURCES: MEDLINE, PsychINFO, SocioAbstracts, and ERIC. A systematic search of each database was performed in April/May of 2003, and then again in October/November of 2003. REVIEW METHODS: Articles in English language, peer-reviewed, published in 1990 or thereafter, and reported on research conducted in the United States, were included in the study. The investigators screened a total of 11,196 titles and abstracts; reviewed 1,612 full-length articles; abstracted data from 265 articles onto evidence tables and ultimately analyzed evidence abstracted from 67 studies. They reported a risk factor as consistently associated with violence if at least 75 percent of articles reported a statistically significant association (p < 0.05) between the specific risk factor and a violence-related outcome. The investigators considered an intervention to be effective if one or more violent outcome indicators were reported to be significantly different (p < 0.05). RESULTS: Male gender, not low family socioeconomic status (SES), was consistently reported to be significantly associated with youth violence perpetration. Co-occurrence of family SES with other risk factors could be associated with youth violence. Among studies that specifically focused on adolescent males, we identified a consistent significant association between violence and anger, cigarette smoking, and non-violent delinquency. For adolescent females, we identified a consistent significant association between violence and non-violent delinquency. The number of studies on the effectiveness of prevention interventions, was too small for the detection of any systematic differences among programs with different characteristics. CONCLUSIONS: The investigators found little agreement with respect to the definitions used to measure youth violence and ways in which risk/protective factors are conceptualized, operationally defined, measured, analyzed, and reported. They recommend that researchers nationwide initiate efforts to develop comparable approaches to defining, measuring, analyzing, and publishing research data related to youth violence.